Venue: County Hall, Worcester
Contact: Emma James /Jo Weston Overview & Scrutiny Officers
Apologies and Welcome
Apologies had been received from Mr P Grove.
Declarations of Interest
Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 13 May 2019). Enquiries can be made through the telephone number/email address below.
Confirmation of the Minutes of the Previous Meeting
The Minutes of the Meeting held on 14 March 2019 were agreed as a correct record and signed by the Chairman.
Attending for this Item were:
Worcestershire County Council (WCC)
Richard Keble, Assistant Director of Adult Services
Worcestershire Clinical Commissioning Groups (CCGs)
Chris Cashmore, Urgent Care Lead
Worcestershire Health and Care NHS Trust (WHCT)
Jan Austin, Associate Director of Countywide Community Services
Sharon Buckley, Urgent Care Strategic Lead
Members were informed that unfortunately Representatives from Worcestershire Acute Hospitals NHS Trust could not be present, however, any questions which could not be answered at the meeting would be taken away for action.
The Panel had requested an overview on Delayed Transfers of Care (DTOC), in order to understand more about the subject and appreciate the respective roles of the Council and Health partners. Members of the Health Overview and Scrutiny Committee (HOSC) had also been invited to attend and participate, due to the relevance of the HOSC’s scrutiny of health services.
The Panel received a presentation, which would be circulated to Members following the meeting. During the presentation, the Assistant Director highlighted that:
· A DTOC was the period of time it took someone to leave or be transferred from a hospital (Acute, Community or Mental Health) to an alternative setting after they had been deemed Medically Fit for Discharge (MFD)
· The time period was measured in whole days
· A delay meant that beds were unnecessarily occupied, which slowed down flow through the hospital and impacted on A&E, both in relation to wait times and ambulance handovers
· For patients, delays impacted on fully recovering independence
· Delays were assigned into one of ten categories and responsibility for delays were either classed as NHS, Social Care or Joint. Weekly meetings were held with all parties to ensure that the reason and responsibility were agreed
· Data was reported in a number of different ways; however, the Department of Health required the number of delays per day per 100,000 population. For Worcestershire, the 2018-19 target was 12.5 and in February 2019, performance was at 12.9 delays per day per 100,000 across all providers
· For the period January to March 2019, Worcestershire Health and Care NHS Trust reported around 10.5% of delayed patients occupying beds, in comparison to 3% for Worcestershire Acute Hospitals NHS Trust. This was a positive reflection on the work undertaken to focus resources on keeping patients flowing through the acute hospitals
· Although patient numbers were small, out of area delays were often lengthier as the process was more difficult to manage at a distance
· It was felt that delays due to patient choice and housing issues could be reduced
In the ensuing discussion, the following main points were raised:
· The Clinical Commissioning Groups had a role in managing and challenging DTOC across the system and was very clear that resources were focussed on assisting the flow through the acute hospitals. This had resulted in positive results, whereby reported figures were following the national trajectory
· Worcestershire Health and Care NHS Trust was responsible for community hospitals and as the focus was on acute services, the challenge had shifted. It was stressed that discharge from ... view the full minutes text for item 317.
There was nothing to add to the current Work Programme, however, when looking at the refresh for 2019/20, Members suggested the following areas for consideration by the Overview and Scrutiny Performance Board in July:
· Feedback from ‘Making Decisions about your Future’ summer roadshows and general awareness of how the Directorate engages with residents in relation to what their needs are and how residents can plan for their future social care and health needs
· Health and Social Care inequalities
· Regular review of the Adult Services Business Plan.